Rasheed Abassi: Why Male Infertility is on the Rise

Rasheed Abassi, a United States trained Doctor and Medical Director of Heritage Men’s Clinic, in an interview with Adedayo Adejobi, explains why male infertility is on the rise. He also speaks on the key nutrients and supplements needed to enhance reproduction, and the role of government in stemming the tide of male infertility occasioned by drinking water not containing zinc

What is this quality of drinking water and male reproductive system scientific discovery all about?

What the research reveals is that access to safe and fortified clean public water is critical to male reproductive system. Around 17.5% of the adult population – roughly 1 in 6 worldwide – experience infertility. The presence of trace elements and minerals like zinc, fluoride, selenide and calcium in the public water system is essential in the production of viable and healthy sperm production in men. Zinc as a matter of fact, is key to a man’s sperm motility. Without adequate motile sperms, the chance of fertilizing a woman’s egg is drastically reduced.

Having been in the practice of men’s health for over 19 years, focusing on how a man’s body works has been my life’s work. In Africa, we think infertility is usually a woman’s problem. But now, the data tells that about 40-45% men are infertile. Research shows that one of the trace elements, zinc is only gotten from the public water. All the bottled water are all pure, but they do not have any supplement in them. No fluoride, zinc or calcium. And all these are needed for the full development of any man. To be a father, you need all these supplements, and you will not get them from bottled water.

Zinc is essential in our immune development and critical in enhancing a man’s sperm motility. During the analysis of a man’s Seminal Fluid Analysis (SFA), We look at three major indices: the amount of sperm produced, the percentage that is well formed and the percentage that is actively moving (motility factor): Zinc is critical to all the three indices, but crucially to the motility factor.

The prostate will add fructose and zinc which is essential for the sperm’s motility. If you make enough sperm and your sperm is not moving, it will not find the woman’s egg, and there will be no pregnancy. Zinc is extremely vital in male fertility. Worthy of note, semen is produced from the testicle where the testosterone is. As a man, to make a lot of sperm, you must be well-hydrated.

How come most bottled water in Nigeria doesn’t have zinc?

That is the big gorilla in the room and a question the government and healthcare professionals should be asking producers of bottled water. The producers of bottled water are business people. They do the bare minimum which is to produce just clean, pure water. That is the task our government gave them. From the public health angle, we should be able to do better: We need more than just purity, we need the essential trace minerals to be included: zinc, calcium and fluoride. It is a public health issue and we deserve better.

Is it that all bottled waters don’t have zinc, or some have and others don’t?

I have yet to see any bottled water in Nigeria with any form of supplement. They are all pure, but there’s none containing supplements, no fluoride, no zinc, none in their bottled water.

Do you have data on this and what does the data say in figures?

Yes, I do. 25 million bottles of water are sold daily in Nigeria, and that tells us water manufacturers are making a kill. The appropriate regulatory bodies need to come up with guidelines and enforce the mandatory addition of zinc, calcium, and fluoride for consumption in our water.

Can the government insist producers of bottled water must have zinc in the water? Does it cost much to have zinc in bottled water?

It doesn’t require new research, as the information is abundant and in the public domain. They just need to adopt a copy-and-paste approach, but they will want to spend the bare minimum to maximise profit. The Federal Government and National Agency for Food and Drugs Administration (NAFDAC) need to make zinc and fluoride, a compulsory requirement in sachet and bottled water Nigerians consume. This would come at a cost to water producers, but there has to be a corporate social responsibility from these businessmen. Multivitamins are an alternative to getting zinc from bottled water. Crucially, Nigerians need to be educated consumers.

This seems a cash-intensive venture for water producers, what policy action do you recommend the federal government take?

It is at a great cost and that’s also a big infrastructure development. The federal government, health Minister, lawmakers, and educated consumers need to make water a priority. It’s either we invest now or we pay a higher price later in terms of a healthy newborn and strong family structure.

In the Western world, does their water contain zinc?

Yes, it is absolutely mandatory to have zinc and fluoride in the water, and it’s regulated by the Food and Drug Association (FDA). So, when you go to the store and ones without zinc and fluoride, its slightly cheaper and there’s a disclaimer. The decision is yours to make.

Let’s talk making babies. Does the presence of these nutrients impact the health of the babies?

When we talk about semen which is the spermatogenesis, when we analyse them at the Heritage Men’s Clinic, we look at three modalities; how much is a man making in each ejaculation, and how much of that is well-formed? When you don’t have enough of these supplements, your body just will not make enough healthy semen. The amount of Sperm a man makes during each ejaculation is key to fertility. Men need all the support: A good level of hydration, an adequate amount of these essential trace minerals and elements along with good blood flow. A healthy newborn is a result of healthy sperm production.

Women also drink water, so why does the man have to bear the brunt?

Firstly, I am a men’s doctor, and so I only see men in my clinic. These are the issues we deal with every day. There might be research about women because for decades we’ve all thought infertility was a women’s issue, but now we know better. Men account for roughly 45% of infertility cases. Traditionally, men don’t go to the doctor because the subject of erectile dysfunction and getting a woman pregnant is very personal and it affects who we are and our self-esteem. Besides, stigma is a big factor.

Do all the men you meet and examine drink bottled water? and what do you recommend?

For men who have a problem, they want the solution. And so, we offer them treatments because there are zinc supplements besides the tablets. There are zinc injections that you can give them and you let them see the importance of that, and you’ll be amazed when they come back to you a few weeks later. When you repeat the semen analysis, you see the changes.

What kind of relationship should young aspiring fathers have with their bottled water?

Be educated consumers. We are what we eat and if you permit me, we are what we drink. Water is key and very essential in the reproductive cycle of any man. Let’s be wise and do the needful.

 Aside infertility, what other risks do men face by drinking bottled water without zinc, calcium etc.?

Data says the zinc, fructose, calcium and fluoride, are not only essential for semen production but also for prostate gland health. When the prostate doesn’t get enough nutrients, there will be the emergence of an enlarged prostate. Whether you want to make babies or not, the prostate needs to be a healthy organ. And it needs fructose, zinc, and calcium abundantly from our diet. This can be supplemented by the water.

What kind of meals would you recommend aspiring fathers to consume?

Future fathers should avoid eating swallows like Eba, Amala and pounded yam late at night because these foods divert blood flow away from the brain which releases chemicals to the testicles. There’s nothing wrong with them, but there has to be portion control because most of these foods have heavy carbohydrates. We need portion and calorie control. And the timing of these heavy meals is also key.

What about rice?

Yes, rice is fine. Eat lots of wheat especially if its unprocessed. Eat lots of your pap. Oatmeal is excellent for you. Cloves are also good for men’s health.

For a bottled water drinker, if one is to be deliberate about zinc, fluoride, calcium, and other supplements intake, how soon before it gets to that optimal level?

In six weeks you get that adequate amount that sips into your semen. Because it has minimal blood flow, you have to consume your bottled water daily and then get your multivitamins, and appropriate organic balanced diet. Your bottled water has to either be lukewarm or room temperature. But if you are active, let it be a little warmer. Cold water is not good for you because of your temperate. The hormones and enzymes work better when the temperature is lukewarm or a little warmer. Keeping bottled water in the car, and exposing it to sunlight is unsafe for drinking. Constituents of the plastic have heavy bad chemicals that will melt into the water, and so it makes it unsafe.

Men need to be aware and make conscious decisions to check their health. There is nothing stigmatising about men’s infertility. and that it’s not only a woman’s problem. Infertility affects both Gender.